Archive for June, 2013

Although Lustig’s hypothesis that the fructose in sugar being the root cause of a host of metabolic problems and America’s obesity epidemic seems quite sound, it is in part due to the strength of his voice in the academic field. Most people do not hear of other objections to his research, including me. However, I recently came across David Despain’s blog Evolving Health that included an interview with Dr. John Sievenpiper of St. Michael’s Hospital, University of Toronto. Sievenpiper is also a qualified expert in the field: he is the lead author of three recent systematic reviews and meta-analyses evaluating fructose’s effects on body weight, blood pressure, and glycemic control in humans from randomized controlled feeding trials.

One of his main arguments is that the studies Lustig uses to support his claims were made on animals, which cannot be directly translated to the effects of fructose on humans.

I think you hit the nail on the head. There is really the disconnect between animal carbohydrate metabolism and human carbohydrate (or fructose) metabolisms. One of my criticisms of using animal data is that they feed at superphysiological levels at 60 percent energy. No one is consuming that.

The heart of Lustig’s argument has been that fructose consumption causes the generation of dangerous fat in the liver. However,

On top of that, we know that if you look at comparative physiological studies, animals metabolize carbohydrates differently than do humans. In animals on a high-carbohydrate diet not providing excess energy, you find that de novo lipogenesis [conversion by the liver to fatty acids] is anywhere from 50 percent or higher. They basically make fatty acids for at least 50 percent of the carbohydrate [consumed]. De novo lipogenesis accounts for at least 50 percent carbohydrate. In humans, it is very, very hard under isocaloric (neutral energy) conditions, let alone in overfeeding conditions, to push that beyond 10 percent or even 20 percent.

Also, in many of the studies he cites, the animals are given a super-physiological amount of fructose, thus skewing data.

It is easy to get caught up in the one sided view of “fructose as poison”, so the purpose of this post was to temper my own perspective a bit. Sure, fructose is still bad, but I think society could use a little more balanced view. And again, nothing in science is absolute. We certainly do not want this to happen:

That’s the danger — that people will say that fruit is a source of fructose and I won’t consume fruit because it may induce obesity, metabolic syndrome, and so on. It’s not just the lay public that may take this message to heart but professionals. We had an endocrinologist here at our hospital at University of Toronto who was telling patients not to consume fruit because of the fructose content precisely because of all the commentaries, editorials, and reviews that Rob Lustig had been publishing. The danger is that people will take the message to extreme. They’ll start saying “I should cut these things out (apples, pears) to cut my fructose exposure.” That is a really wrong-headed approach. When I talk to Dr. Lustig on the side, I do get a sense that he does think that there’s a dose threshold, but it doesn’t come out in the writing, or the YouTube piece.

The Center for Science in the Public Interest, an independent research/advocacy group for health made a petition to the FDA in February of this year to ensure the safe use of added sugars. It was made on the grounds that the FDA had pledged back in 1982 and 1988 that they would reassess the safety of sweetners if consumption increased or there was sufficient science to back up that ingredients like HFCS or sucrose were a public health hazard. Thus because we now know that obviously, sugar has become a major health issue, the CSPI could make their petition more credible.

The petition is the embodiment of what I think needs to be done in Washington, and what first steps policywise America can take. In other words, I approve (not that my own personal approval matters too much to politicians)

The petition outlined its actions requested:

1. the FDA initiate a rule-making proceeding to ensure that the content of sucrose and HFCS in beverages is limited to safe levels consistent with authoritative recommendations.

2. With respect to sucrose, HFCS, and other added sugars (GRAS or otherwise), FDA:

• Revise the “Sugars” line on Nutrition Facts labels to address “added sugars”;
• Set targets for lower levels of added sugars in foods (apart from soft drinks and
other beverages) that provide significant amounts of sugar to the general
population or population sub-groups;
• Conduct a public education campaign to encourage consumers to consume less
added sugars; and
• Work with the food industry and interested federal, state, and local agencies to
encourage reduced use and consumption of added sugars—including by
encouraging (1)limits on the sale of over-sized beverages containing added
sugars in restaurants and from vending machines and (2) the development of
means of reducing the use of added sugars.

Of course, (I hate to be negative) most of these requests will not be granted. However, I would love to continue to support the cause in any way I can. I was hoping to get Austin Health Department’s support for the petition, or maybe use a version of this petition (with the CSPI’s support) in front of the Texas legislature.

I’ve talked enough about how I am going to put all this knowledge into application and “make an impact”. But enough of that. This summer, I really am going to

TAKE ACTION.

It’s the hardest thing to actually do because although I have plans for what to do, things never go as planned. I’ve already tried to contact a couple of people who seem to have an influence/vested interest in the field, but they do not ever respond.

So, here is what I propose.

1. Continue to research about the science/current policies.

2. After my SAT’s, I will make a brochure to hand out to the public warranting my cause.

3. I will contact my local doctors offices and ask if I can place the brochures in their waiting rooms

4. I will contact my local senators/congressmen to ask if I can further present my cause/ lobby for change. I have specific policy proposals in mind. Later post on that.

5. If #4 happens, I will get a group together. If #4 does not happen, I will get a group regardless to go and hand out brochures in public spaces.

6. Hopefully, by that point, I will have caught the attention of someone with power who can support the cause.